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Post by Former NIMH Director Thomas Insel: More on Public Trust and Conflict of Interest

By Thomas Insel on June 15, 2010

A recent story in the Chronicle of Higher Education implied that a quid pro quo relationship existed between me and Dr. Charles Nemeroff, formerly of Emory University. This story suggested incorrectly that Dr. Nemeroff helped me get a position at Emory in 1994, and that I assisted him in securing a position at the University of Miami after he was sanctioned for violations of financial conflict of interest rules at Emory. By switching from Emory to Miami, Dr. Nemeroff escaped a 2 year ban on applying for NIH grants, imposed by Emory. Senator Charles Grassley (R-IA), a leading voice in the effort to reduce conflict of interest in biomedical research, has asked the Office of the Inspector General at HHS to look into this matter.

Having been one of the most outspoken proponents for developing tougher conflict of interest policies at NIH, the allegations that I would help anyone avoid penalties struck me as surreal. Here are the facts:

Dr. Nemeroff was chairman of psychiatry at Emory School of Medicine in 1994 when I was recruited by the Vice President of Health Affairs to be Director of the Yerkes Primate Center, an appointment outside the School of Medicine. To my knowledge, Dr. Nemeroff had no significant impact on my selection.*

Did I assist Dr. Nemeroff in getting a job at Miami? When Dean Goldschmidt of the University of Miami contacted me for a recommendation, I agreed to speak with him informally by phone. NIH institute directors are routinely consulted about recruitments in academia, especially for department chairs. My policy has been not to provide recommendations, but I respond to requests for information. In this case, the Dean had a specific question about Dr. Nemeroff’s eligibility to apply for NIH grants. I explained that the penalties were imposed by Emory and according to the current policy, Dr. Nemeroff was not prevented by NIH from applying for grants.

While my response to Dean Goldschmidt was simply to describe the facts, in retrospect it would have been better to refer the Dean’s specific question about Dr. Nemeroff’s grant eligibility to someone from the NIH Office of Extramural Research, which coordinated the investigation of Emory University. But let’s be clear -- my intent in this conversation was to explain a federal policy, not to exploit a policy that would help any investigator avoid penalties.

I realize that my tenure at Emory and a previous association with Dr. Nemeroff will, for some, be “guilt by association.” To avoid such allegations, I recused myself from all matters involving Dr. Nemeroff during the conflict of interest investigation at NIH. While I have had no contact with Dr. Nemeroff for many months, to avoid any possibility of a perception of either positive or negative bias, I will recuse myself from future applications or NIH matters involving Dr. Nemeroff. Note however, that I must comply with the current policy which permits someone to apply for NIH funding unless they have been de-barred.

Though some of the facts have been distorted, there is a serious issue here, but also a chance for timely resolution. NIH is currently in the midst of revising its financial conflict of interest regulations. A Notice of Proposed Rulemaking was posted on May 21, 2010, encouraging public comments by July 20, 2010. In a meeting of the NIH Advisory Committee last week, Director Francis Collins noted that the recent situation with Dr. Nemeroff is encouraging NIH leadership to explore ways to require that future institutional sanctions against a scientist travel with that person. Dr. Collins also indicated that NIH is looking into strategies that would prevent a sanctioned investigator from serving on NIH review or advisory panels during the time of the institutional penalty. I strongly support the need for those actions.

Institute directors are public servants. As Director of NIMH, my primary obligation is to individuals and families struggling with serious mental illness. Every decision I make is based on this simple calculus: what is best for those we serve? Importantly, those we serve are patients and families; those we fund are a means to this end.

*I acknowledge that this description may be viewed as misleading. In fact, Dr. Nemeroff served on the search committee at Emory, and my recruitment as Yerkes Director included an academic appointment in the Department of Psychiatry and Behavioral Science, then chaired by Dr. Nemeroff, in the Emory University School of Medicine, as well as an academic appointment in the Department of Psychology in the Emory University College of Arts and Sciences. Although my understanding is that Dr. Nemeroff did not play a supportive role in my hiring, I have no way of actually knowing all the facts.